NPI | 1376015610 |
---|---|
Entity Type | Organization |
Authorized Contact | STACY CLOYD Secretary 904-605-4986 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
Enumeration Date | 2018-12-27 |
Last Update Date | 2023-07-25 |